Obama Acts to Ease Flu Fears; U.S. Says It Is Prepared

The Obama administration dispatched high-level officials from several agencies to demonstrate that it was fully prepared to confront the outbreak.

ROBERT PEAR and GARDINER HARRIS

WASHINGTON — The Obama administration dispatched high-level officials from several agencies Monday to allay concerns about swine flu and to demonstrate that it was fully prepared to confront the outbreak even as the president said there was “not a cause for alarm.”

Janet Napolitano, the secretary of homeland security, and Dr. Richard E. Besser, the acting director of the Centers for Disease Control and Prevention, said the administration was prepared to respond to any further spread of the swine flu virus.

Homeland security officials said they expected the outbreak to spread. “We are proceeding as if we are preparatory to a full pandemic level,” Ms. Napolitano said.

As the administration responds to its first domestic emergency, it is building on concrete preparations made during the tenure of President George W. Bush that have won praise from public health experts. But its actions are also informed by what Mr. Bush learned in his response to Hurricane Katrina: that political management of a crisis, and of public expectations, can be as important as the immediate response.

In a speech at the National Academy of Sciences on Monday, Mr. Obama said only a few words about swine flu. “This is, obviously, a cause for concern and requires a heightened state of alert,” he said. “But it’s not a cause for alarm.”

But behind the scenes at the White House, aides said the president was directing his administration to be ready in case an alarm needed to be sounded. A full report on the swine flu was added to Mr. Obama’s daily intelligence briefing, with updates given to him throughout the day.

Aides said they were mindful that how the president conducted himself in this period, both substantively and stylistically, would be long remembered. But they adamantly rejected the idea that this situation was at all comparable to that of the hurricanes that devastated the Gulf Coast in 2005.

Finding the right mix of alarm and reassurance is a delicate task for an elected official.

Eric Toner, a senior associate at the Center for Biosecurity at the University of Pittsburgh Medical Center, said: “It can be very dangerous to overreact. And it can be very dangerous to underreact.” So far, Mr. Toner said, Obama administration officials “have managed to get it just right.”

Other public health experts also endorsed the administration’s response to the outbreak that emerged from Mexico. They gave much of the credit to President Bush, whose administration did extensive planning for such an emergency.

“We’re seeing a payoff of the original investment made in pandemic preparedness by the Bush administration,” said Jeffrey W. Levi, executive director of Trust for America’s Health. The term pandemic refers to a widespread outbreak of an infectious disease.

Frances Fragos Townsend, who was assistant to President Bush for homeland security and counterterrorism, noted that the Department of Health and Human Services had devised a detailed plan for responding to the threat of pandemic flu in 2005 and 2006.

On his summer vacation in 2005, Mr. Bush read “The Great Influenza,” a history of the 1918 pandemic by John M. Barry.

Mr. Obama also displayed interest in pandemic flu in 2005. Within months of taking office as a senator, he introduced a bill to step up preparations, saying: “We are in a race against time. The nation’s health officials have made some progress in preparing for pandemic influenza. Yet we have much work to do.”

The swine flu outbreak has been linked to 149 deaths in Mexico. In the United States, the number of confirmed cases grew to 50 on Monday.

While experts praised the Obama administration’s initial response, many warned that a more extensive outbreak of swine flu could tax the nation’s public health capabilities.

“If this gets worse, you’ll see the weakness of our system,” said Dr. Jeffrey P. Koplan, a former director of the Centers for Disease Control and Prevention. “In an event like this, where everyone’s well-being is dependent on everyone else’s, we will both feel and see the problems our system creates.”

Dr. Irwin Redlener, director of the National Center for Disaster Preparedness at Columbia University, said federal officials reported six years ago that hospitals would need far more beds, ventilators and personal protective equipment to respond to a pandemic. Hospitals never got nearly enough extra equipment, Dr. Redlener said.

“We will pay a very heavy price for this if we get the big one,” he said.

The White House press secretary, Robert Gibbs, said Monday that the administration was not at a disadvantage because of vacancies in top federal health positions.

“Our response is in no way hindered or hampered,” Mr. Gibbs said. When pressed to say whether White House officials would prefer to have a full team in place, he said, “We’d rather not have a swine flu.”

Dr. June E. Osborn, former dean of the School of Public Health at the University of Michigan, said the Obama administration appeared to be responding effectively, even without a secretary of health and human services.

Mr. Obama’s nominee for health secretary, Gov. Kathleen Sebelius of Kansas, is waiting for Senate confirmation. Senate action has been delayed in part by Republican questions about Ms. Sebelius’s views on abortion.

On Tuesday, the Senate is scheduled to begin debate on the nomination, under an agreement that will require 60 votes for confirmation.

Twenty positions at the Department of Health and Human Services are filled by the president, subject to Senate confirmation. Mr. Obama has nominated people to fill five of those positions, and none have been confirmed.

Dr. Besser, the acting director of the Centers for Disease Control, brings his experience as a past director of the Office for Terrorism Preparedness and Emergency Response at the centers to his task of dealing with the swine flu threat.

Ms. Napolitano said her agency went into the crisis with more than a dozen vacancies in senior positions, including the commissioner for customs and border patrol, the assistant secretary for health affairs and the under secretary for intelligence analysis. She said those jobs were being handled by career civil servants, working from detailed contingency plans inherited from the Bush administration.

Dr. Nicole Lurie, director of the public health preparedness program at the RAND Corporation, said, “The federal government has come together with a pretty good, unified response” to the swine flu outbreak.

From the Hurricane Katrina experience, Dr. Lurie said, federal officials learned “the importance of coordinating the government response, communicating with the public and mobilizing equipment” as fast as possible.

In recent years, she said, federal, state and local officials have conducted many exercises so they would be prepared to respond to emergencies.

Since 2005, federal and state governments have spent more than $1.5 billion to stockpile Tamiflu and Relenza, antiviral medicines recommended by the government to treat infection with the swine flu virus.